Most of us
imagine that we will have our own children when we grow up.

After all,
the happiest memories we have is when we were children , and just like we are
grateful to our parents for bringing us up, we want to be parents too , so that
we can bring our children up , and pass on the family traditions we've inherited.

This is a
deep biological urge , and it can come as a rude shock when you find that you
can't have a baby. Infertility can create a huge void in your life – and the
impact is similar to that of a death in the family – the death of your hopes
and dreams.

The good news
is that technology exists to solve this problem , and IVF can solve pretty much
bypass all the medical problems which afflict infertile couples.

Sadly, patients
are very scared about doing IVF , because they're worried that it has side
effects ; or that it's very expensive . To add to their confusion, they are not
sure which IVF doctor they should go to.

Here's an
option which is completely risk-free because it’s free ! Ask me for a second
opinion at www.drmalpani.com/free-second-opinion - you have nothing to lose and everything to gain !

There are no
strings attached ! I'm an IVF specialist, and I'll be happy to tell you what
you need to do in order to have a baby !

Saturday, December 15, 2018

This is especially
true when IVF doctors promise them the moon , and are extremely optimistic when
they want them to sign up for treatment.

However, when
the cycle fails, their hopes come crashing down.

Not only are
they depressed and frustrated, they lose confidence in doctors - especially
when the doctor abandons them , and refuses to answer their calls or provide
them any information as to why the cycle failed, and what they can do
differently next time.

Patients feel
cheated and will not trust any other IVF doctor.

This is why a
shared risk option can be so valuable , and this is well-worth exploring , because
both the patient and the IVF clinic are making a long-term commitment that they
will work together until the patient finally gets a baby, because their
interests are aligned.

This is
something that you should discuss with your IVF doctor , so that you don't
continue remaining depressed , and lose your best chance of getting pregnant.

Find a better
IVF clinic which has the courage of its convictions and is willing to put their
money where their mouth is !

Thursday, December 13, 2018

In the past , standard IVF protocols for superovulation would use down-regulation with GnRH agonists ( such as Lupron) , and these were known as either the short or the long protocols. Long protocols would start 7 days before the cycle started, which meant that patients would end up having to take shots for 20 days – a daunting prospect for most women, and because this put them off, they refused to explore the option of doing IVF

The newer protocol uses the GnRH antagonist ( such as Cetrorelix) , which means that patients require fewer injections. Not only is this kinder for the patient, it's also less expensive. Even better , we usually collect more eggs, and their quality is better too. Finally, the cherry on the cake is that it reduces the risk of ovarian hyperstimulation, which means it provides lots of benefits without any risks !

This is called the Letrozole Antagon protocol, which uses a combination of Letrozole , which helps the patient grow more of their own endogenous follicle-stimulating hormone, in combination with Gonal F, which is exogenous follicle-stimulating hormone. This starts from Day 2 of the cycle, and this combination of both internal and external hormones helps the patient to grow more eggs. Because we use the GnRH antagonist for down-regulation from Day 7 onwards, we can trigger ovulation with a GnRH agonist, so that the risk of hyperstimulation is zero.

This new protocol allows both patients and doctors to get the best of both worlds - better and more eggs, with lesser risk and fewer injections !

Wednesday, December 12, 2018

Patients
with ovarian failure can be very depressed and disheartened when they learn
that they can't have a baby with their own eggs .

Lots of them
are not prepared to accept this harsh truth, and are not willing to use donor eggs
, even though this has a very high success rate, either for psychological or religious
reasons. As a result of their desperation, they are emotionally very vulnerable
, and are happy to clutch at straws. Because they're willing to do anything in
order to have a baby, it’s easy for crooked doctors to cheat them . In the past
, doctors would take them for a ride, by “treating” them with hormone
replacement therapy. This would allow them to get regular cycles, and they
would then believe that their problem has been fixed – but this as just giving
them false hope.

Today , the
scams have become a lot more sophisticated , and the newest buzzword is “ Ovarian
Rejuvenation Therapy “, which is selling like hot cakes.

The doctors
claim that they are able to use “scientific techniques” to reactivate the dormant ovarian stem cells in
your ovaries , by injecting potions into them, such as PRP or plasma enriched
platelets.

They dress
this up in very impressive scientific terms, but all these claims are hocus
pocus – they don’t work. Please don’t get carried away, and just use your
common sense. If it really worked, wouldn’t all doctors offer this option to
their patients !

In order to
protect themselves, these doctors call this “ experimental therapy” , but please don’t allow
them to use you as a guinea pig – this is just a scam to exploit your
desperation, and make you part with your money !

Tuesday, December 11, 2018

It can be
difficult to treat infertile patients, especially when they have very
unrealistic expectations of what medicine can do for them.

This is
because their feelings range wildly all the way from one end of the pendulum - false
hope, to the other end - false despair.

False hope
is the expectation that I'm going to get pregnant if I do IVF ; or that IVF has
a 100% success rate .

Patients who
do IVF treatment with this false hope will often go to pieces when their cycle
fails , because they're not able to build up the courage to try again . Because
they had such high (unrealistic) expectations , they cannot deal with the
frustration and the unhappiness and the heartbreak this causes.

False
despair is the other end of the pendulum , and just because three IVF cycles
have failed is no reason to give up ! This doesn't mean that the fourth cycle
is going to fail as well – sometimes all you need to do is to find a better
doctor !

This is why
it's important that patients find the right balance between false hope and
false despair – and the best way of doing this is through Information Therapy !

Monday, December 10, 2018

No, it's
not because her pregnancy test has come back negative, because she is still in
her 2ww, and hasn't got her result as yet . It's because she's been very
disillusioned and disappointed by the quality of medical care which she has
received during her IVF treatment.

Her IVF
doctor has not shared any information with her - in fact, she hasn't even seen
the same doctor twice ! The only time she met the doctor was at the time of the
first consultation, when everyone was very sweet, and wanted her to pay her
fees, so they could start her treatment as soon as possible . Sadly, they were
more interested in collecting her fees, rather than in helping her to have a
baby !

During her
IVF treatment, every time she went to the clinic, she had to talk to a junior doctor,
a nurse, or an assistant , who had no clue about what was happening. The senior doctor wasalways busy – either she was travelling, or
was in the OT. She never bothered to return her phone calls, which meant that
she was in suspense throughout her cycle. When she asked questions, the
standard answer was, "We don't know. We will have to talk to the senior
doctor , and she will decide."

She didn’t even
know simple basics, such as how many follicles were seen during the ultrasound
scans; or how many eggs are collected; or what the quality of her embryos was.
Everything was mysterious, and completely opaque. This just made hereven more anxious and concerned , because she
didn’t have any idea what was happening to her.

This is one
of the reasons why so many patients refuse to do a second IVF cycle - because
they've been so unhappy with the experience they've had with their first IVF
cycle.

In order to
prevent this tragedy, you need to do your homework, and go to the right clinic ,
so you have a happy experience. Good clinics routinely share information with
their patients; document all their treatment; and provide patients with photos
of their embryos as a standard practice.

Please
don’t allow an IVF doctor to cheat you – you have too much at stake !

Sunday, December 09, 2018

These two
IVF clinics look very similar. Their equipment seems to be the same, and their
websites seem to have the same text ( since one of them has copied and pasted
the content from the other!)

So how are
patients going to differentiate between the two clinics ? How do they know
which one is good, and which one is not?

This is a
huge problem, and it’s very hard for patients to identify a good clinic.

It’s not
just the equipment which a clinic has – after all, they can all buy the same
hardware !

In reality,
it’s the experience and the expertise of the team members which makes a world
of
difference !

You need to
look for someone who does only IVF , because this is their full time focus.You need a doctor who provides care from a
single clinic, so you know they are not running around from clinic to clinic in
order to grab more patients and earn more money !

You need a
doctor who has enough experience and
expertise to be able to deliver results, so that you are confident that you are
getting the best possible medical care.

Finally, good
IVF clinics take pride in being open and transparent , and in sharing
information with their patients. They educate them , so that they have peace of
mind that they've received the best possible medical care !

Saturday, December 08, 2018

A lot of
couples are worried that IVF babies are weaker than other babies, or have a
higher risk of having birth defects.

Yes, it is
true that IVF babies are different, and what makes them different is the fact
that they're special, because their parents spend so much time and energy on nurturing them, because they're so deeply loved.

From a
biological perspective, an IVF baby is exactly like any other normal baby, and
this is hardly surprising given the fact that all we're doing in an IVF cycle
is mimicking nature. In simple terms, IVF allows us to do what’s not happening
in the bedroom in the IVF lab.

Instead of
the sperm fertilizing the eggs in the Fallopian tube ( like they do normally
for fertile couples) , we're fertilizing them in the test tube in the IVF lab ,
and then transferring the embryo into the uterus.

This is why
there is no increased risk of birth defects, and this can be very reassuring
for patients !

It's high
time that we busted a lot of these myths surrounding IVF babies !

Friday, December 07, 2018

No, it's
not because her pregnancy test has come back as positive because she is still in her 2ww, and hasn’t
done it so far. It’s only been one week since her embryo transfer, and while
she is hopeful and optimistic, she's not sure whether the cycle is going to work
or not.

Interestingly,
even if the cycle fails, she will continue smiling, because she's had such a great experience
during her IVF treatment.

Her doctor
has been open and transparent, and has shared information with her throughout
the cycle. The team has been respectful, has treated her like an intelligent
adult.

They have shown
her the follicles and the uterus during her ultrasound scans, and she has been
given photos of her blastocysts, so that she has peace of mind that she has
received top quality medical care.

She
understands that the outcome of any IVF cycle is neither in her hands , nor in
her doctor's, because implantation is a biological process which no one can control.
However, she is confident that because she's received good quality medical care,
she has done everything humanly possible, and this gives her enormous peace of
mind.

If you want
to smile during your IVF cycle as well, please make sure that you are well
informed and well prepared !

Thursday, December 06, 2018

The whole point
is that an IVF pregnancy is exactly like any other pregnancy !

Just because
an embryo spends five days in the IVF laboratory , this doesn't make the
pregnancy any different – once it implants, it follows exactly the same course
every other pregnancy does.

This is why
I'm so unhappy when so many obstetricians do routine Cesarean sections for
their IVF patients . They justify this be saying that these are very precious
pregnancies. But every pregnancy is precious for its parents, and there's
really no reason to medicalize a pregnancy, just because IVF was done.

This is why
IVF patients need to find a confident obstetrician , who can reassure you !

You should be
happy to be finally pregnant , and you should have the pleasure of experiencing
pregnancy and normal childbirth as well, because you're a healthy woman who
should be happy that your body works properly.

A goodOB will give you every opportunity to do so,
rather than try to medicalize everything, just because you've done IVF !

Wednesday, December 05, 2018

Lots of out-of-Mumbai patients are reluctant to travel to Mumbai to our clinic for their
IVF treatment, even though they know our IVF pregnancy rates are the best in
the country.

This is because they've been told all kinds of horror stories
about IVF treatment.

They have
been misinformed that they need to visit the clinic everyday; that they need daily
ultrasound scans; that they require injections on a daily basis which need to
be given at the clinic; they need bed rest after the transfer; and that travel after
the embryo transfer is unsafe.

They are
also warned that IVF pregnancies need special care, and this can only be
provided locally, which is why they are scared to come to Mumbai.

However,
none of this is true at all. These are just
myths which are propagated by local IVF clinics in their town , in order to hold
onto their patients, and make sure that they don't travel outside the city. This
is a shame, because pregnancy rates in these local clinics aren't good, but
they don't want to lose their patients.

The fact of
the matter is that IVF logistics is very simple. We provide a well-defined clear treatment plan which is easy to follow.
No hospitalization is required, and patients only need to come to clinic about 4-5 times over a 15 day
period.

A IVF
patient was just telling me about how the expert advice which she gets has
driven her crazy. Interestingly, this is not advice from doctors – it’s advice
from all the friends and relatives around her , who keep on telling her what
she should be doing in order to get pregnant.

While the uncertainty
which surrounds the outcome of an IVF cycle can be nerve-wracking , the fact that these busybodies pry into your
personal affairs , and offer you gratuitous advice, just makes matter much
worse.

They think
they are IVF experts, and are happy to tell you what you should do in order to
get pregnant after an IVF cycle, based on their extensive experience of what they
know about IVF, since their cousin’s friend , who did an IVF cycle in Delhi and got
pregnant , has kindly shared all the gory details with them.

The advice the
provide is poor quality , and because it often conflicts with what the doctor
says, it causes more confusion than anything else. Sadly, IVF patients are emotionally
vulnerable, and don’t know whom to trust !

To add
insult to injury, by giving patients bad advice – for example, that they need bed
rest after IVF, they compound problems, because they end up blaming the victim
in case the cycle fails !

Why depend
upon poorly informed friends for IVF advice when I am happy to give this to you
free ?

Everyone
agrees that transferring a single embryo is best for IVF patients. This is
called an Elective Single Embryo Transfer, and the best clinical only transfer one,
top quality blastocyst, because singleton pregnancies have a much better
obstetric outcome and are safer for both mother and baby.

After all, the
purpose of IVF is not just to get pregnant - it's to have a healthy baby !

Even with
twins, the risk of premature delivery is increased, with all the consequences
of low birth weight and mental retardation this can cause. It might seem tempting
to have twins because this gives you an “instant complete family at one shot” ,
but this is not in your best interests.

This is why
it worries me why a lot of IVF doctors
will talk about doing Single Embryo Transfers when giving lectures at
conferences, but in real life they will actually push their patients into
transferring two embryos !

I think this
just reflects the fact that they're not very confident about their IVF success
rates.

Thus, if
your doctor tells you to transfer two embryos, this is a red flag, which
suggests he may not be very good. What he seems to want to do is to maximize
his clinic's success rates, rather than to maximize your chance of having a
healthy baby- and this is not in your best interests, because you then run the
risk of being saddled with handicapped babies for the rest of your life !

After the embryo transfer , the commonest question husbands ask is - What can I do to increase the chances of my wife getting pregnant ?

My answer is simple – please pamper your wife , and give her all the attention that she wants !

Now this may not sound very scientific , but the reality is that once we have transferred the embryo back into the uterus, we cannot control the natural biological process which occurs in utero. Neither diet, activity, rest , stress of exercise will affect the fate of the embryo.

There's absolutely no need for bedrest, and no need for any dietary restrictions either. What happens inside the uterus after IVF is exactly what happens after fertile couples have sex in the bedroom ! IVF really doesn't change anything, and there's no need to take any special precautions. The only difference is that the IVF patient knows there’s an embryo inside her – something which fertile couples are blissfully unaware off, until they get pregnant !

The pampering is helpful , because it’s good for women to feel loved and cared for ! I don’t have any evidence that this improves pregnancy rates , but I truly believes it helps !